I can't even recall all the medications I have been on in the past 8 years I have been diagnosed with bipolar 2. Most had side effects, or just plain didn't work. And when you start talking about dosage...oh my goodness...up, down every couple of months as my doc and I try to tweak to the right combo to keep my mood level. Despite all the work we do, I still continue to cycle..albeit much more mild cycles than before. But I cycle enough to cause trouble with overspending, sleeping too much, etc.
My current regimen is Abilify, Lamictal, Klonopin, Zoloft, and Adderall. But I think I have taken every psych drug know to be useful, and some not! for bipolar disorder.
In less than 5 minutes, I was diagnosed as bipolar in 1995. And this was by a research psychiatrist, not even a clinical psychiatrist, because that was who was immediately available, and I was in crisis. And in that 5 minutes, she determined I should be on Trilafon. No discussion of what bipolar meant, no discussion of medication effects and side effects. To give her some credit, she did assign me to a regular clinical pdoc whom I was able to see 2-3 weeks later. But the first time I took Trilafon, it paralyzed my facial muscles into a kind of gargoyle's mask. Or at least that's what it felt like. I called this doctor and she said not to take it anymore. But with the new pdoc, he started me on one mood stabilizer after another, along with thyroid medication and an antidepressant. Nothing worked. (I didn't feel any better.) Then the meds were switched with new ones about every 6 weeks. I gained weight on some, lost on others. But it was about 2 years before I switched to a different doctor, who followed through with the same routine. No change, not even with ECT. My third pdoc was very young and just starting his practice. I found a therapist who would listen. This doctor, with whom I have stayed since 1997, was much more "down to earth" and included my mother in my monthly appointments. But he, too, started me on a new regimen of antidepressants, and took me off of Eskalith, Xanax and Prozac. And I began taking Zyprexa which was terribly sedating and caused an appetite surge and resulting weight gain of almost 100 lbs. But it started stabilizing my moods and the psychosis began to fade. And when I started taking Wellbutrin in 2004, and later added Zoloft, everything improved. Now, I take Wellbutrin 300mg, Zoloft 200mg, Trazodone 75mg, Klonopin 0.5 mgs, and Saphris 10mgs. Whatever I had to go through all those years of med changes was worth it in the long run...if that was indeed the solution. Sometimes I think it is more than medication though. There are a lot of things like CBT and nutrition and exercise that also contribute to recovery. But doctors don't seem as keen on these interventions. Even the "down to earth" doctors.
Fell asleep while driving on Geodon & had such incredible dizziness that I had to lie down on the floor at work (not very professional!). Writing w/one hand as had surgery on left hand yesterday so excuse all the typos, please.
Started w/Depakote when finally changed to internal med doc--already taking Xanax at night (& was in mixed episode & dxed bipolar 1 after about 30 yrs of being dxed w/unipolar depression as was seeing GP & didn't go in when hypo manic--felt good then; had been on every anti-deppressant that pushed me into hypo mania for about 8 weeks--then a crash). Mother had schizo affective & committed suicide when I was 15 (many attempts myself). IM doc sent me to pdoc.
Depakote helped w/agitation but not depression. Started IOP at hospital (did about 8 weeks) & put on Lithium & Provigil (for excessive daytime sleepiness; had sleep study). LOVED Lithium--never felt so good, but had to get off after a few mos. due to kidney malfunction. Really miss the wonderful feeling while on Lithium, but have some kidney damage from just those few mos.
Than Abilify (had paranoid thoughts & delusional--thought husband wanted me to kill myself or he was going to kill me). Lamictal, Xanax at night (Trazodone added later), Concerta for ADHD, Provigil (life saver as so tired all the time), Wellbutrin one winter when got really depressed--SAD--sit under full-spectrum light now so off Wellbutrin. Also B-12 shots (pernicious anemia) & thyroid medication.
Off Abilify (w/pdoc's approval) after 12 yrs. as improved so much w/DBT & indiv. therapy. Think of therapy & DBT as "medicine." Plan to do rest of my life (3 yrs. of weekly DBT so far--very helpful in teaching new thinking & coping skills). Lowered dosage of Lamictal w/pdoc's approval. Would like to get off Lamictal as getting elderly (57 now), but when tried to get off completely went into depression.
Pdoc wanted to add some Seroquel when started having really bad insomnia but already gained 50 lbs. on Abilfy so said no. Did EMDR w/therapist--helped a lot w/insomnia.
I have been on a variety of medication since I was diagnosed over 25 years ago and have been through many medication changes. My doctor has explained that as a woman, the hormone changes that our bodies go through will affect how our medication works and that changes to the meds will be necessary throughout life. I am currently going through menopause and with bipolar that has given us some challenges with the meds, but my psychiatrist comes through with flying colours every time! I accepted my fate with this illness from day one - it has not always been easy, but I frequently read these articles and books from others that 'suffer' through life with this uphill challenge. Be patient, love yourself (this isn't your fault), encourage your family and friends to read and understand how this truly affects us, get out and walk (this has helped me immensely). I am currently on 6 different medications - some I take in the morning and some at night - they help me to:
1. Live
2. Love
3. Respect myself
4. Understand the plight of others (Compassion)
5. Be able to hold a good job
I could go on with my list but those are some of the most important.
I was diagnosed with several disorders back in 2000. Since then, I have taken ALMOST every medication out there, besides the tricyclics and the MAOI's and Lithium. Those meds I will not take no matter what, mainly because of side effects that can be pretty terrible and serious.
I can't even count how many med changes I have been through since diagnosis...more than anybody I have encountered so far. And I can't find anyone who has been through as many meds that I have been on as well.
Current medications:
Lamictal
Adderall
Strattera
Wellbutrin
Atarax
Xanax
Abilify
Prolixin
I hate to be on so many meds, but I think I'm doing fairly well, as compared to how I felt and functioned in the past. I'd noticed about 2003 that the more meds you take, the crappier you'll feel. In my experience anyway...then switched pdocs and was taken off many of the meds, and ended up feeling soooo much better...like not feeling drugged up all the time nor having any serious or intolerable side effects.
One of my first med combos included Depakote and Zyprexa, which I didn't question and just took them because the pdoc said to. No discussion of what they were for nor what the side effects would be...including an EXTREME possibilty of gaining an EXTREME amount of weight. If I would have been told that, I never would have taken them, for sure. I gained just over 100 pounds from both of them. The first 25 pounds was gained ine first 3 weeks, and the rest over a period of about 8 months. I was very naive then. Now, I'm well education both about medication and different mental disorders. I feel that I can advocate for myself and stand on my own two feet. As for the weight gain, in January of this year, I had the lap band surgery. So far I've lost about 35 pounds (since the last time I weighed myself anyway). I can tell the difference already...I've already gone down a pant size as well, so that's exciting. I have saved all my clothes from when I was thinner, and I pray so hard that I will be able to wear them again (even though I was a size 10 then, which is high in some people's eyes), I always called myself fat back then, but now I know what being fat REALLY is! So, if I ever get down to a size 10 again, I will NEVER call myself fat again. I looove those clothes sooo much. Now, I just mainly wear clothes from Walmart, as finances are terrible.
Anyway...end ramble.
Dana
I kinow how you feel. I have had more med changes over the last 13 years than I care to think about and each time it was getting used to a new set of side effects and new dosage schedules which kept screwing with my appetite and my sleep. Right now, hey put me on a pretty good regime but who k nows what will happen in the near or distant future and that scares me.
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so you are now on:
1) mood stabilizer - Lamictal
2) anti-psychotic (though no note of psychosis but used primarily for sleep regulation which the APs are now all too commonly prescribed) - Seroquel
3) a tranq - though Trazodone isn't a tranq, it's overly sedating effects helps it to be a sleep aid/tranq
4) an anti-depressant - Cymbalta - which is also used for pain management
and a PRN benzo/tranq - if needed
and yet, you note in so many words basically - as it read to me - that though this now combination is good... it's not great
which means...
you are still having symptoms or feelings that you find distressing to some degree?
First off, Seroquel has a twofold action for me - as both a sedative and an antidepressant. (In fact, I was a part of the clinical trial that got Seroquel approved specifically for treating depressive episodes of bipolar disorder.) I take a very low dose (1/6 of the amount recommended as maintenance dose for bipolar depression) but it definitely helps, as I took a big step backward when I went from 50mg to 25.
In addition, I have a sleep disorder aside from bipolar disorder. Until I went on psych meds I hadn't had a good night's sleep in 20 years, leading to fibromyalgia. So Cymbalta is a good fit for me. My fibro is well though not perfectly controlled by taking Cymbalta, Seroquel and Trazodone.
This combination, with Lamictal, is the best I've had for a long time. I have bad days and good days, but I no longer have depressive episodes lasting weeks or months (knock wood). The longest string of bad days I've had this year was five days, and they weren't black depression.
I dont know what is usual or not, but I think my doctor only adds one thing at a time, or in weaning, takes away one thing at a time? Maybe that is not always possible: I was on a combination of sub therapeutic doses and each was removed one at time and replaced. one at a time. over a long period, many months. Because I was on a dog's breakfast of drugs (wording was that of my psychiatrist). Seroquel time release acts like a different drug than the regular. Extended release came out in Canada, approved in 2009. Continued tinkering with meds is pretty tiresome, but the adjusting medication can be done in a systematic way? It seems that there are too many factors for side effects with too much switching of more than one at a time. and the combinations are not always well known....(not well studied). I advocate pharmaceutical patience and caution.
I have tried and/or been on so many drugs since age of 10 (am 44.5). Mostly ADs with a few 1st generation anti-psychotics and only 2 of the 2nd generation anti-psychotics... only to now be prescribed a 3rd of the 2nd generation anti-psychotics.
The ADs: If they did not put me suicidal, they did literally nothing... "pooped" out... gave me hallucinations... or such hideous side effects that were life threatening (NMS and EPS) that I just refuse to do anymore ADs... even if the pdoc insists. I've tried each class of them so far. They simply do not work for me.
The anti-convulsants/mood stabilizers: Only one that really does anything for me is Lithium and it's the only true Bipolar med and the oldest Bipolar med. The only thing it does for me is kill the suicidal thoughts and the impulse in which to act on the thoughts.
Otherwise, I gain weight.. have diarrhea daily... have tremors... and blurry vision. I also become quite lethargic and very apathetic. I feel as though I'm walking dead. It does not lift my depression, not one bit but man it kills any "up" feeling I'd surely ever muster.
The anti-psychotics: So far.. Seroquel and Abilify. Seroquel was 12.5 mg from having gone nearly 10 weeks with only about 3-4 hours of sleep - when I slept. I gained 25 lbs in the month I took it and developed a fever, stiff leg muscles, and stiff neck. I slept as though I was on a Mickey and was comatosed nearly the entire day. Hard to raise children and work full time when you couldn't stay awake OR think. The doc took me off of it.
The abilify.. 1st and only dose... I had the lips puckering, knee was knotted, and my right leg kept jerking... literally jerking. I also wanted to sleep the entire day and was half in and half out.
I've had seizures from meds, I've had countless number of hives. I've had my eyes and face swell, I've had my tongue turn black. I've had cardiac arrithymias and I've fainted. Then I've had the nausea, vomiting, diarrhea so bad you didn't know you were coming or going and passed yourself on the way to the toilet.
I've been semi-vegatated, void of the ability to think, memories eroded, unable to pee without doing a special dance on the toilet seat to loosen and encourage my bladder. I've had to wear black sunglasses under flourescent lights, at work, just to barely see because my eyes were always dilated and the highway would swerve and turnover in front of me.
And the entire time... I never ever ever "felt" better. Except for maybe the Thorazine cause I honest to G do not remember the 6 months on that except for wearing sunglasses and doing the dance on the toilet to pee. Outside of that... don't remember a single event, thought, or conversation I had. That... comes the closest to "feeling" better (oh and gained 46 lbs on it when I came off of it and realized I was living).
If I ever actually "felt" better... and the meds would actually "take" me... and I could still actually function while I "felt" better and they took me... I think I'd be so much better... If....